<!DOCTYPE html>
<html lang="zh-cn">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta http-equiv="X-UA-Compatible" content="IE=edge">
<meta name="viewport" content="width=device-width, initial-scale=1.0, maximum-scale=1.0, user-scalable=no" />
<meta name="renderer" content="webkit">
<title></title>
<link rel="stylesheet" href="__PUBLIC__/css/pintuer.css">
<link rel="stylesheet" href="__PUBLIC__/css/admin.css">
<script src="__PUBLIC__/js/jquery.js"></script>
<script src="__PUBLIC__/js/pintuer.js"></script>
</head>
<body>
<div class="panel admin-panel margin-top" id="add">
  <div class="panel-head"><strong><span class="icon-pencil-square-o"></span> 商家积分充值</strong></div>
  <div class="body-content">
    <form method="post" class="form-x" action="__URL__/buyTo">
        <input type="hidden" class="input w50" value="{$res[0].shop_id}" name="id"/>
      
      <div class="form-group">
        <div class="label">
          <label>充值对象：</label>
        </div>
        <div class="field">
        	<input type="text" name="phone" id="phone" value="" class="input w50" data-validate="required:请输入电话"/>
          <div class="tips"></div>
        </div>
      </div>   
      <div class="form-group">
        <div class="label">
          <label>充值数量：</label>
        </div>
        <div class="field">
        	<input type="text" name="num" id="num" value="" class="input w50" data-validate="required:请输入数量"/>
          <div class="tips"></div>
        </div>
      </div>

      <div class="form-group">
        <div class="label">
          <label></label>
        </div>
        <div class="field">
          <input class="button bg-main icon-check-square-o" type="submit"  value="提交" /> 
        </div>
      </div>
    </form>
  </div>
</div>
</body>
</html>